全腔镜与右胸小切口房间隔缺损修补术效果的回顾性队列研究  

The surgical effects of total endoscopy and right thoracic small-incision for atrial septal defect repair:A retrospective cohort study

作　　者：刘琳 陈甜园 鲍洁 LIU Lin;CHEN Tianyuan;BAO Jie(Department of Anesthesia and Perioperative Medicine,The First Affiliated Hospital of Nanjing Medical University,Nanjing,210029,P.R.China)

机构地区：[1]南京医科大学第一附属医院麻醉与围手术期医学科,南京210029

出　　处：《中国胸心血管外科临床杂志》2022年第4期463-466,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的比较全腔镜与右胸小切口房间隔缺损修补术的手术效果。方法纳入2019年在南京医科大学第一附属医院行体外循环(cardiopulmonary bypass,CPB)下房间隔缺损修补术的60例患者,按手术方式的不同将其分为两组:右胸小切口组(31例),其中男11例、女20例,年龄(44.5±11.5)岁;胸腔镜手术组(29例),其中男12例、女17例,年龄(46.5±12.7)岁。比较两组患者的临床资料。结果两组患者一般临床资料差异无统计学意义(P>0.05)。所有患者均顺利完成手术,术后无死亡病例。胸腔镜手术组术后24 h胸腔引流量[(59.1±43.9)mL vs.(91.0±72.9)mL,P=0.046]、红细胞输入量[(78.0±63.9)mL vs.(121.0±88.7)mL,P=0.036]、术后住院时间[(5.5±2.1)d vs.(7.2±2.1)d,P=0.003]、术后并发症发生率(6.9%vs.22.6%,P=0.029)明显优于右胸小切口组,差异有统计学意义;两组手术时间、CPB时间、主动脉阻断时间、机械通气时间、ICU滞留时间、术后中重度疼痛患者比例差异无统计学意义(P>0.05)。结论两种术式均安全有效,行胸腔镜下房间隔缺损修补术患者创伤小、术后住院时间短、疼痛轻、切口美观、无骨骼损伤,值得临床推广。Objective To compare the surgical effects of total endoscopy and right thoracic small-incision for atrial septal defect repair.Methods The clinical data of 60 patients undergoing atrial septal defect repair in our hospital in 2019 under cardiopulmonary bypass(CPB)were collected.The patients were divided into two groups according to different surgical methods:a right thoracic small-incision group(n=31),including 11 males and 20 females,aged44.5±11.5 years;a thoracoscopic surgery group(n=29),including 12 males and 17 females,aged 46.5±12.7 years.The clinical data were compared between the two groups.Results The baseline data of the patients were not statistically different(P>0.05).The surgeries were successfully completed in the two groups of patients.The volume of chest drainage in 24 h after the surgery(59.1±43.9 mL vs.91.0±72.9 mL,P=0.046),red blood cell input(78.0±63.9 mL vs.121.0±88.7 mL,P=0.036),length of postoperative hospital stay(5.5±2.1 d vs.7.2±2.1 d,P=0.003),postoperative complications rate(6.9%vs.22.6%,P=0.029)in the thoracoscopic surgery group were significantly better than those in the right thoracic smallincision group.There was no significant difference in the CPB time,aorta blocking time,operation time,mechanical ventilation time,ICU retention time or postoperative pain score between the two groups(P>0.05).Conclusion The two techniques are safe and effective.Patients undergoing thoracoscopic repair of atrial septal defect have small trauma,short postoperative hospital stay,mild pain,beautiful incision,and no bone damage,which is worthy of clinical promotion.

关 键 词：胸腔镜手术 房间隔缺损 体外循环 右胸小切口 回顾性队列研究 

分 类 号：R654.2[医药卫生—外科学]